Bethany Ehrhart relapsed on heroin while in rehab at the Betty Ford Clinic. / WUSA

by Donna Leinwand Leger and Andrea McCarren, USA TODAY

by Donna Leinwand Leger and Andrea McCarren, USA TODAY

When Bethany Ehrhart, 23, wanted to kick her addiction to painkillers, her mother, Darlene, found the money for top-of-the-line treatment at the world-renowned Betty Ford Center. A week after her arrival at the celebrity rehab in Rancho Mirage, Calif., Ehrhart says, a fellow patient gave her heroin smuggled in on visitors' day.

Ehrhart, just days into detox, says she was powerless to resist the pull of her addiction, took the heroin and plunged into relapse, surrounded by the counselors paid top dollar to help her.

Ehrhart says she witnessed a drug deal at the rehab center and told a staff member, who failed to report it. In an e-mail to Ehrhart's mother, Betty Ford's former CEO John Schwarzlose, who left the post in July, promised an investigation, offered the family free services and refunded Ehrhart's tuition. Ehrhart transferred to another rehab center.

"We take your concerns very seriously," he wrote.

Betty Ford spokesman Russ Patrick declined to comment on Ehrhart's specific allegations, citing anonymity for patients in a 12-step recovery program and confidentiality laws for health care providers, but Patrick said in a statement that the center "has zero tolerance for drug use on campus."

"During our 31-year history of treating thousands of addicted patients, a very small number of them have tried to get drugs on campus," Patrick said.

Drug addictions are notoriously difficult to kick. Studies from the National Institute on Drug Abuse found that 40% to 60% of people treated for drug addiction relapse, a rate similar to other chronic diseases such as hypertension, asthma and diabetes.

"Addicts will go to great lengths to get drugs," said Carol Falkowski, former director of the Alcohol and Drug Abuse Division at Minnesota's Department of Human Services, who also worked for a decade at the Hazelden Foundation. Staff members know addicts will often entice friends, family or their former dealers to smuggle drugs into rehab for them, she said.

Recent examples include:

â?¢ Prosecutors in New Jersey arrested seven men, including five employees, in July on charges of distributing heroin, crack cocaine and painkillers to patients at Veterans Affairs treatment facilities. "These seven men abused their access to VA medical facilities to peddle dangerous drugs to other veterans undergoing treatment," U.S. Attorney Paul Fishman said.

â?¢ In March, a patient at a locked state drug treatment center in Fergus Falls, Minn., was sentenced to four years in prison after she and two other patients used heroin and other drugs they had smuggled into the facility, said Otter Tail County assistant prosecutor Michelle Eldien. An accomplice outside the center smuggled the drugs into the rehab in shampoo bottles and pockets of jeans, she said.

The breach led to an internal review and security audit, Minnesota Department of Human Services spokeswoman Karen Smigielski said. The facility has new procedures, including making clients undress on admission for a contraband search, she said.

Falkowski, now president of Drug Abuse Dialogues, an educational organization on drug and alcohol abuse in Minnesota, has heard stories of desperate addicts trying to distill fruit pilfered from the cafeteria into alcohol. At a treatment center where Falkowski worked in the 1970s, workers found drug syringes hidden in a clothes dryer.

"It happens all the time," Falkowski said. "Historically, it's something that every treatment center has to deal with."

Patients use Internet chat rooms to discuss schemes for obtaining drugs. In one discussion forum on rehab that lasted five years from 2004 to 2009 on the Internet site Bluelight.ru, patients recounted dozens of incidents of drug use in rehab. One former patient described a dealer who would deliver drugs inside a tennis ball that he would bounce up to a third-floor window.

"You would put your money in the ball, bounce it down and then he would throw it back up with the amount of dope you wanted," a user with the screen name "blahblahblah" wrote.

Drug rehabs can take concrete steps to keep drugs out and must anticipate the risks addicts will take to feed their addictions, said Ben Levenson, CEO of Origins Recovery Centers, which has two gender-segregated drug rehab facilities on South Padre Island in Texas.

"These are survivors. They are super resourceful. Many of them are super bright. They try everything. I've seen them hide pills in the seams of their dress shirts," he said.

Origins has a long list of policies and procedures to keep contraband out, including thorough searches of the patients and twice weekly drug testing, Levenson said. The facility carefully screens its employees with deep background checks and regular drug testing

Origins treats 40 men and 32 women at a time in gender-segregated facilities, with two employees for every patient, Levensen said. Staff would halt drug use immediately, he said.

"They can't hide," he said. "People will notice that they are high. Being high at Origins would be absolutely miserable. You'd rather just leave."

The Betty Ford Center has a highly trained security team that includes a dog trained to detect drugs, strict protocols for all visitors and random drug testing of patients, Patrick, the spokesman, said.

"Whenever drug use has been discovered, despite our precautions, we act immediately, and we do more than stop the specific use discovered," he said. "We investigate why such use occurred and update our security protocols as warranted."

Security is now tighter than it was last year, he said.

By the time Ehrhart arrived at Betty Ford on May 28 for a 90-day treatment program, her addiction had overtaken her life. She said she spent $200 to $300 a day to purchase oxycodone, a narcotic painkiller.

A few days into the $62,000 treatment program, Darlene Ehrhart said her daughter called sobbing, asking to come home. She said she had witnessed another patient purchase drugs.

Darlene Ehrhart shrugged it off, figuring her daughter wanted to weasel out of drug treatment as withdrawal hit.

Bethany Ehrhart said she told her counselor and a patient advocate that she heard discussions about drugs that would arrive on visiting day and witnessed people getting high.

"I got the vibe that this was an anything-goes facility," Ehrhart said.

After another call from Ehrhart, her mother called her daughter's counselor. The counselor promised to take care it. But on a Sunday visiting day in early June, Ehrhart used a needle to shoot heroin that she said was brought to the rehab facility by a visitor.

"I didn't care because it was there. I wanted it. I was just ready for it," Ehrhart said. "I was waiting for it for days."

Four days after the incident, Ehrhart transferred to another treatment program that she successfully completed on Aug. 3. Now she says she is clean, working as a barista in a coffee shop and planning to return to school in January.